What happens under the flexor tendons of the fingers in dactylitis?

IF 1.8 4区医学 Q2 ACOUSTICS

Medical Ultrasonography Pub Date : 2023-03-30 DOI:10.11152/mu-4026

Esperanza Naredo, Raquel Largo, Otto Olivas-Vergara, Carmen Herencia, Myriam Mateos-Fernández, Carlos Miquel García-de-Pereda-Notario, José Ramón Mérida-Velasco, Gabriel Herrero-Beaumont, Jorge Murillo-González

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Abstract

Aim: Tenosynovitis is one of the most frequently described inflammatory lesions in psoriatic dactylitis. The aim of the study was to assess by ultrasound the distribution of content within the synovial sheath of the finger flexor tendons in a cadaveric experimental model of tenosynovitis and to describe anatomically the elements of the space between the flexor tendons and the palmar aspect of the proximal phalanx of the fingers.

Material and method: Silicone was injected under ultrasound guidance into the digital flexor sheath of the index finger of a hand specimen. Ultrasound images of the distribution of the filling of the flexor synovial space with the injected material were obtained. These images were compared with images from patients with psoriatic dactylitis. The palmar regions of the hand and fingers were dissected to check the distribution of the injected silicone in the synovial cavity. Additionally, we dissected the 2nd to 5th fingers of five cadaveric hands, including the one used for the experiment.

Results: During the injection of the substance, we observed an increasing homogeneous hypoechoic band around the flexor tendons that differed from the images of patients. Dissection of the specimen showed the injected silicone distributed throughout the digital flexor sheath to the distal interphalangeal joint. In addition, we provided an illustrated anatomical description of the elements located between the flexor tendons and the palmar aspect of the proximal phalanx, the inflammation of which could simulate flexor tenosynovitis.

Conclusion: The observations of this study may contribute to a better understanding of the anatomical structures involved in PsA dactylitis.

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指炎时手指屈肌腱下发生了什么?

目的:腱鞘炎是银屑病指炎中最常见的炎性病变之一。该研究的目的是通过超声评估在腱鞘炎尸体实验模型中的手指屈肌腱滑膜鞘内的内容分布，并从解剖学上描述屈肌腱和手指近端指骨掌面之间的空间元素。材料与方法:在超声引导下，将硅胶注入手部标本食指指屈肌鞘内。超声图像显示了注射材料填充屈肌滑膜间隙的分布。将这些图像与银屑病指炎患者的图像进行比较。解剖手部和手指掌区，检查注射硅胶在滑膜腔内的分布。此外，我们解剖了五只尸体手的第二到第五指，包括用于实验的那只手。结果:在注射该物质时，我们观察到屈肌腱周围均匀的低回声带增加，与患者的图像不同。解剖标本显示注射的硅胶分布在整个指屈肌鞘到远端指间关节。此外，我们提供了位于屈肌腱和近端指骨掌面之间的元素的解剖描述，其炎症可以模拟屈肌腱腱鞘炎。结论:本研究的观察结果可能有助于更好地了解PsA指突炎的解剖结构。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Ultrasonography RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

3.20

自引率

5.90%

发文量

期刊介绍： The journal aims to promote ultrasound diagnosis by publishing papers in a variety of categories, including editorial letters, original papers, review articles, pictorial essays, technical developments, case reports, letters to the editor or occasional special reports (fundamental, clinical as well as methodological and educational papers). The papers published cover the whole spectrum of the applications of diagnostic medical ultrasonography, including basic science and therapeutic applications. The journal hosts information regarding the society''s activities, scheduling of accredited training courses in ultrasound diagnosis, as well as the agenda of national and international scientific events.